Bed rest may reduce surgery rates among patients with osteoporotic vertebral fractures
Published data showed that hospitalization for two weeks can reduce the number patients with osteoporotic vertebral injuries and poor prognostic MRI findings.
Researchers identified all 65-year-old patients with osteoporotic vertebral injuries. They were treated at both facilities within two weeks of injury. Patients were then followed for six months. Researchers found that one hospital required patients to rest for two weeks (n=116), while another hospital instructed patients not to rest (n=108). Researchers also classified patients based on whether or not they had MRI results that were poor prognostic. Researchers used the rate at which patients transitioned to surgery as their primary end point. Secondary end points included bone union rate, vertebral kyphosis progression, bone progression, and changes in daily activities.
The mean progression of osteoporotic vertebral injuries was 6.4% and 20%, respectively, in patients who received instructions to rest or not to rest. Funayama T. et al. J Bone Joint Surg Am. 2022;doi:10.2106/JBJS.22.00116.
The results showed that 45 patients in a rest group and 37 in a no rest group had poor prognostic MRI findings. Three patients in a rest group required surgery, while nine in the no-rest group needed it. Researchers found that the rates of surgery were not significantly different between the no and rest groups. Results showed that patients with poor prognostic MRI results in the rest group had significantly lower rates of surgery.
According to the results, there were no significant differences between patients in the two groups in terms of bone union rate or changes in daily activities. Researchers discovered a 6.4% average progression in vertebral collapse in the rest group, and 20.9% for the no rest group. Researchers also found a mean local progression of kyphosis of 2.4deg for the rest group, and 8.8deg for the no rest group.